Peer-reviewed article
Strengthening mental health and research training in Sub-Saharan Africa (SMART Africa): Uganda study protocol
Fred M. Ssewamala, Ozge Sensoy Bahar, Mary M. McKay, Kimberly Hoagwood, Keng‐Yen Huang et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study protocol describes a planned trial testing the Multiple Family Group (MFG) intervention for children with behavioral disorders in Uganda. The intervention will be delivered through schools by either trained family peers or community health workers and compared to usual care. The study will involve 3,000 child-caregiver pairs across 30 public primary schools in semi-urban and rural areas, with measurements at baseline, 8 weeks, 16 weeks, and 6-month follow-up. The research aims to test whether this evidence-based practice from developed countries works effectively in Uganda and to understand what factors affect its implementation.
Key points
- Children in Sub-Saharan Africa represent half the regional population but mental health services are severely under-equipped
- The study uses a hybrid type II effectiveness-implementation design with three arms: MFG by trained parent peers, MFG by community health workers, and usual care comparison
- The intervention targets children aged 8-13 years (grades 2-7) in primary schools across semi-urban and rural communities
- The study employs task-shifting by training parent peers and community health workers to deliver the intervention rather than specialist mental health workers
- Data collection spans baseline through 6-month follow-up across 30 schools with random assignment to study conditions
Limitations
This is a study protocol document that describes planned research rather than completed results, so it cannot provide evidence of effectiveness or implementation outcomes. The actual findings, challenges encountered during implementation, and real-world effectiveness data are not yet available.
Abstract
BACKGROUND: Children in Sub-Saharan Africa (SSA) comprise half of the total regional population, yet existing mental health services are severely under-equipped to meet their needs. Although effective interventions for the treatment of disruptive behavioral disorders (DBDs) in youth have been tested in high-poverty and high-stress communities in developed countries, and are relevant for widespread dissemination in low- and middle-income countries (LMICs), most of these evidence-based practices (EBPs) have not been utilized in SSA, a region heavily impacted by poverty, diseases including HIV/AIDS, and violence. Thus, this paper presents a protocol for a scale-up longitudinal experimental study that uses a mixed-methods, hybrid type II, effectiveness implementation design to test the effectiveness of an EBP, called Multiple Family Group (MFG) aimed at improving child behavioral challenges in Uganda while concurrently examining the multi-level factors that influence uptake, implementation, sustainment, and youth outcomes. METHODS: The MFG intervention will be implemented and tested via a longitudinal experimental study conducted across 30 public primary schools located in both semi-urban and rural communities. The schools will be randomly assigned to three study conditions (n = 10 per study condition): (1) MFG delivered by trained family peers; (2) MFG delivered by community health workers; or; (3) comparison: usual care comprising mental health care support materials, bolstered with school support materials. A total of 3000 children (ages 8 to 13 years; grades 2 to 7) and their caregivers (N = 3000 dyads); 60 parent peers, and 60 community health workers will be recruited. Each study condition will comprise of 1000 child-caregiver dyads. Data will be collected at baseline, 8 and 16 weeks, and 6-month follow-up. DISCUSSION: This project is the first to test the effectiveness of the MFG intervention while concurrently examining multi-level factors that influence overall implementation of a family-based intervention provided in schools and aimed at reaching the large child population with mental health service needs in Uganda. Moreover, the study draws upon an EBP that has already been tested for delivery by parent peers and community facilitators, and hence will take advantage of the advancing science behind task-shifting. If successful, the project has great potential to address global child mental health needs. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03081195 . Registered on 16 March 2017.